Corticosteroid therapy for patients with CoVID-19 pneumonia: a before-after study

BANI-SADR, Firouzé; HENTZIEN, Maxime; PASCARD, Madeline; N'GUYEN, Yohan; SERVETTAZ, Amélie; ANDREOLETTI, Laurent; KANAGARATNAM, Lukshe; JOLLY, Damien

BACKGROUND: Anti-inflammatory drugs such as corticosteroids may beneficially modulate the host inflammatory response to CoVID-19 pneumonia. AIMS: To evaluate the impact of addition of corticosteroids to the hospital protocol for treatment of suspected or confirmed CoVID-19 pneumonia on rates of death or intensive care unit (ICU) admission. METHODS: A before-after study was performed to evaluate the effect of addition of corticosteroids to our institution's COVID-19 treatment protocol on hospital mortality. RESULTS: Between March 3(rd) and April 14(th) 2020, 257 patients with CoVID-19 diagnosis were included. As corticosteroids were wide used since 27 March 2020, two periods were considered for the purposes of our study: the before period from March 3(rd) to 20(th) (n= 85) and the “after period” (n=172) from March 26(th) to April 14(th) 2020. The “after” period was associated with a lower risk of death (HR 0.47; 95% CI, 0.23 - 0.97; p=0.04), and a lower risk of intensive care admission or death before ICU admission (HR 0.37 95% CI 0.21 - 0.64; p=0.0005) by multivariate analysis adjusted for age, National Early Warning score and institutionalization status. CONCLUSIONS: In the “after period”, the addition of corticosteroids to our institution's CoVID-19 treatment protocol was associated with a significant reduction in hospital mortality.